Abstract
Purpose :
To investigate the presence of Hyperreflective Retinal Spot (HRS) in patients with Primary Open Angle Glaucoma (POAG) and compare the results to control.
Methods :
27 subjects were enrolled: 15 patients with POAG and 12 healthy subjects, who served as control. All subjects underwent a full ophthalmologic examination and spectral-domain optical coherence tomography (SD-OCT). HRS were evaluated in the macular scan within an area delimited by two vertical lines traced at 1500 µm from the fovea, nasally and temporally. The SD-OCT scans were analyzed by two masked graders who independently counted the HRS.
Results :
Hyperreflective retinal spot were detected in all eyes (100%). According to both graders, there was a significant increase in HRS in glaucomatous patients with respect to healthy subjects. The average number of HRS (±SD) in the glaucomatous group analyzed by the first grader was 101.06 (±16.82), while in the healthy group the average was 75.16 (±16.15). The HRS difference was significant (t11 = 2.99; P < 0.01). The second grader also measured an increase in the number of HRS in patients with glaucoma (102.26 ± 13.94) with respect to healthy subjects (72.83 ± 12.98), with a significant difference in the comparison between the two groups (t11 = 4.85; P < 0.01). No inter-grader nor intra-grader variability was observed when comparing the two graders in the evaluation of HRS (all comparisons P > 0.05).
Conclusions :
Present study showed the increased number of HRS in SD-OCT scans of patients with glaucoma with respect tho the healthy subjects. Considering that HRS were described as inflammatory activated microglial cells, these data are consistent with the most recent pathophysiological studies on glaucomatous neuro-inflammation and neurodegeneration conducted in vitro or in animal studies. This is the first study to provide in vivo evidence of microglial activation in human glaucoma. Further studies could establish a correlation between the number of HRS and glaucoma disease stage: this could confer diagnostic, prognostic and treatment-related implications to HRS evaluation, which may thus be included in the future clinical practice of glaucoma. By prioritizing this aspect, future developments could lead to innovative therapeutic strategies targeted at the inflammatory processes that develop in the pathophysiology of glaucoma.
This is a 2020 ARVO Annual Meeting abstract.